Medical school: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated: 1996
NPI: 1225368665
Practice Locations (2)
4300 SOQUEL DR
SOQUEL, CA 950732150
8315664409
5905 SOQUEL DR, SUITE 200
SOQUEL, CA 950732857
8315664409
Source: CMS National Downloadable File, September 2026.